Abstract
To report a successfully treated case of acquired night blindness associated with fundus white spots secondary to vitamin A deficiency. An ocular examination, electrophysiologic testing, as well as visual field and OCT examinations were obtained on a 61-year-old man with vitamin A deficiency who had previously undergone gastric bypass surgery. The patient had a re-evaluation after treatment with high doses of oral vitamin A. The patient was observed to have numerous white spots in the retina of each eye. Best-corrected visual acuity was initially 20/80 in each eye, which improved to 20/40-1 OU after oral vitamin A therapy for 2 months. Full field electroretinogram (ERG) testing, showed non-detectable rod function and a 34 and 41% reduction for 32-Hz flicker and single flash cone responses, respectively, below the lower limits of normal. Both rod and cone functions markedly improved after initiation of vitamin A therapy. Vitamin A deficiency needs to be considered in a patient with white spots of the retina in the presence of poor night vision.
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References
Harris EW, Loewenstein JI, Azar D (1998) Vitamin A deficiency and its effects on the eye. Int Ophthalmol Clin 38:155–161
Sommer A (1990) Xerophthalmia, keratomalacia and nutritional blindness. Int Ophthalmol 14(3):195–199
Uyemura M (1928) Uber eine merkwurdige augenhintergrundveranerung bei zwei fallen vo idiopathischer hemerlopie. Klin Monatsbl Augenheilkd 81:471–473
Apushkin MA, Fishman GA (2005) Improvement in visual function and fundus findings for a patient with vitamin A-deficient retinopathy. Retina 25(5):650–652
Marmor MF, Fulton AB, Holder GE, Miyake Y, Brigell M, Bach M (2009) Standard for clinical electroretinography (2008 update). Doc Ophthalmol 118:69–77
Slater GH, Ren CJ, Siegel N, Williams T, Barr D, Wolfe B, Dolan K, Fielding GA (2004) Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg 8(1):48–55
Spits Y, De Laey J-J, Leroy BP (2004) Rapid recovery of night blindness due to obesity surgery after vitamin A repletion therapy. Br J Ophthalmol 88(4):583–585
Enat R, Nagler A, Bassan L, Perlman I, Kanter Y, Schramek A, Barzilai D (1984) Night blindness and liver cirrhosis as late complications of jejunoileal bypass surgery for morbid obesity. Isr J Med Sci 20(6):543–546
Scholl HP, Zrenner E (2000) Electrophysiology in the investigation of acquired retinal disorders. Surv Ophthalmol 45:29–47
Sandberg MA, Rosen JB, Berson EL (1977) Cone and rod function in vitamin A deficiency with chronic alcoholism and in retinitis pigmentosa. Am J Ophthalmol 84(5):658–665
Elison JR, Friedman AH, Brodie SE (2004) Acquired subretinal flecks secondary to hypovitaminosis A in a patient with hepatitis C. Doc Ophthalmol 109(3):279–281
Acknowledgments
This study was supported by funds from the Foundation Fighting Blindness, Owings Mills, MD, USA; Grant Healthcare Foundation, Lake Forest, IL, USA; NIH core Grant EYO1792; and an unrestricted departmental grant from Research to Prevent Blindness.
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Genead, M.A., Fishman, G.A. & Lindeman, M. Fundus white spots and acquired night blindness due to vitamin A deficiency. Doc Ophthalmol 119, 229–233 (2009). https://doi.org/10.1007/s10633-009-9200-y
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DOI: https://doi.org/10.1007/s10633-009-9200-y